Foot extensor tendonitis? Resume running?

April 1st, I got myself a nice extensor tendonitis for running too long on the treadmill.

The first two weeks I couldn't run at all, but this week, I managed to run about 3 mi every day at a low pace. Beyond 3 miles, the pain comes back; however, I feel like my foot feels SLIGHTLY better every day.

Should I keep doing that until the pain goes away completely? Or should I see a podiatrist? Any other tips, advice?

Hey! I've dealt with extensor tendinitis off/on this year and currently deal with it. My advice (this goes for any kind of injury, really)...unless you think you have a stress fracture, just keep running. Now, if it really hurts or keeps getting worse, then of course back off and cross train. The human body can withstand running and healing if managed properly, it's only a problem if it is past that point and makes it worse. I have always just kept running, but here some tips: loosen your shoe laces. A lot of the time, the tightly tied laces can press against your tendons and cause inflammation, so just skip the center loops and tie it loosely at the top. ICE after EVERY run. Stretch, point and flexing your foot will help. I do this before I get out of bed every morning. If it gets worse, go see a foot doctor. hope this helped!

Hey guys, it's been now 40 days since I injured myself and it's NOT getting better...

I've seen the podiatrist, he gave me Flector patches (NSAID patches), and told me to take ibuprofen. He also recommended to get a new pair of shoes and got me new orthotics. So I went to a very good shoe store and they gave me Brooks Dyad 7 that I'm wearing 24/7. I've also been icing my foot like 10 times a day for 15minutes, spaced by at least an hour. I'm also taking arnica montana, applying Penetrex ointment, taking calcium, royal jelly. Sometimes I also do Epsom salt soaks. I also tried the friction massage... AND IT SEEMS LIKE NOTHING HELPS! This morning I couldn't even run ONE mile because it was starting to hurt...

Not sure what to do now...I have a marathon in October and I'm really losing hope now.

Hey guys, it's been now 40 days since I injured myself and it's NOT getting better...

I've seen the podiatrist, he gave me Flector patches (NSAID patches), and told me to take ibuprofen. He also recommended to get a new pair of shoes and got me new orthotics. So I went to a very good shoe store and they gave me Brooks Dyad 7 that I'm wearing 24/7. I've also been icing my foot like 10 times a day for 15minutes, spaced by at least an hour. I'm also taking arnica montana, applying Penetrex ointment, taking calcium, royal jelly. Sometimes I also do Epsom salt soaks. I also tried the friction massage... AND IT SEEMS LIKE NOTHING HELPS! This morning I couldn't even run ONE mile because it was starting to hurt...

Not sure what to do now...I have a marathon in October and I'm really losing hope now.

Yes - I've been doing maybe 5 runs a week, 2 miles each. But last week end I pushed to 3 miles and now it's hurting again.

I never think that running through pain, as suggested above, is a good idea. Take a week off and reassess after that. Tedonitis can take quite a while to heal. I suspect you have tenosynovitis, which is different and unfortunately, often takes longer to fully heal.

Hey Pasei, it sounds like you need to rest. I took a pretty solid 4 weeks off from running when I had extensor tendonitis. I was able to walk, even at a brisk pace, without causing any pain to the injury, so I regularly hiked 6-10 miles while I was recovering. I'm not a doctor, but I would definitely suggest not running for at least a week, two, maybe even three or four if you still have pain when you run. Your body will fix itself, you just have to let it. If you're worried about your race, you can still cross train by riding a bike, rowing, hiking, or swimming to keep up your fitness. You just need to give your tendons some relief from what's causing the pain.

When researching recovery methods for my injury, I read several different numbers for how long your body takes to repair tendon damage ranging from 4 to 6 weeks to as long as 3 to 6 months depending on the severity of the damage. I also don't agree with pushing through the pain, especially if it's getting worse. As a runner, you will always have minor aches and pains, but you know whether your hurt or whether your injured. When you're injured you likely need to rest, and allow your body to repair itself.

I think I just developed this today. Grr. I set out on a 17-miler this morning. I'm training for Grandma's Marathon in five weeks. I ran Boston on April 15 in 3:20:59, so I've got a good base.

The run started fine and normally. We were doing two 8.5-mile loops. Just at the end of the first loop I felt some discomfort. I loosened up my laces and things were progressing OK and I thought I could run through it. But by Mile 10.5 I knew I'd have to cut the run short. And at Mile 11.5 I had to stop.

It's VERY sore right now. I'm noticeably limping. Basically, any pressure I put on the bottom of the front part of my foot results in shooting pain. Grrr.

Probably a combination of overuse, laces tied too tightly, my feet swelling (suddenly summer has descended upon Minnesota and my feet were swelling in my shoes), and one to many runs in my shoes.

FYI, I was in my Kinvaras. I've been using those on longer runs and Virratas on about half of my shorter runs. I've run two marathons in Kinvaras without incident. So I don't think it's "minimalist" shoes per se but you never know.

Any thoughts appreciated.

I'm committed to resting this injury. I pulled my hamstring last November pretty significantly, and learned the value of staying off it. It's frustrating, particularly now that the weather is so nice, but it's necessary. And if I can't run Grandma's, it's far from the end of the world.

Not being able to run Boston -- or, worse yet, not being able to have finished Boston because of an injury like this -- would've been MUCH worse. All a matter of perspective.

Anyway, pasei, let us know how you're doing. And any thoughts appreciated.

Hey Steve, thanks for your testimony. Seems like it can happen to very well trained athletes like you too.

Well, 2 months after the initial injury, it's not getting much better. I went to the podiatrist twice: he gave me new orthotics, ibuprofen, made me buy new running shoes, and gave me Flector patches... Only the patches are helping, as they make the foot kind of numb, but it seems like the problem is still there. I haven't run for 2 weeks and yesterday I went to the swimming pool... and the pain came again. Also, my best friend is a D.O. and she "fixed" me for 90 minutes... but I'm not sure it helped much. I'm kind of very depressed now. My last chance is to go to P.T., the podiatrist gave me a prescription for it, but I have little hope. My marathon training starts June 13 and it really seems that I'm not gonna be able to make it.

Also the pain really "travels" through my tendon, sometimes it's above the toes, sometimes above the ankle, and sometimes above the shin splints...

Hi, just picking up on this thread searching for answers on what I think is tenosynovitis or extensor tendonitis. Living in China, my options for professional help are limited, so I really appreciate the information I've seen so far.

Mine started 3 weeks ago after an incredibly unremarkable 6k run. I was running in Vibram 5F like I've been doing for 2+ years, about 4k into a loop, when it started to feel like my shoes were too tight. By the time I got back, I could barely walk. The next day was just as bad, then it slowly receded a bit, but was swollen on the top. I had trouble locating the exact source of the pain - sometimes it was on top of my arch, other times on the outside running from small toe to ankle. I had it x-ray'd and nothing was found. Since then I've made incremental progress, but it's 2 steps forward, 1 & 1/2 back.

Is this similar to what other people experienced? I've been doing short runs, about a mile, and I'm OK during, but in the morning I'm half crippled. The swelling is almost gone, but still there a bit, behind the 2nd and 3rd toes 1/2 way up the arch. I've been taking ibuprofen, not regularly, but want to be sure I'm not masking important signals from my body.

Oh my, pasei, I am SO SORRY to hear that. I'm way too early into recovering from this injury, so I have no sage advice, but I get the "nightmare" reference. I also get the depression, totally. I see others running in my neighborhood and just get ... angry. Not being able to run hits me right at the core. And you've been dealing with this much longer than I have.

Are you willing to share how long you've been running before your injury, and your age? (PM me if you want.)

I'm 46, which concerns me a bit, since I likely won't heal up as if I were 26 or 36. But I have been running since age 19, so I'm hoping my body is used to healing various parts of the running apparatus. I've had tendinitis twice before, and healed 100% before, so I'm hoping for that for myself, and also for you!!

Where does it hurt after swimming? I've been swimming a fair amount, and there's some discomfort but not pain. But there would be pain if I really kicked my feet.

FYI, I did get clearance from the doctor to swim and bike too -- anything that doesn't hurt. The latest on my situation is ... I seemed to be healing OK, but then re-injured the foot Wednesday (four days after the injury) while standing on it while changing shoes. I felt a "snap," went to the sports doc the next day, and got some x-rays. No sign of stress fracture. But the doc gave me the choice of being in an Air Cast, because of how much difficulty I was having walking and because sometimes stress fractures don't show up right away.

I was using the cast consistently till yesterday, when I felt compelled to walk around the block three times without it. Each time, it felt better, and I got a little faster on each 1/3-of-a-mile loop. But I can't imagine running a step for another week and a half, maybe longer.

pasei, did the doc talk about anything similar to an Air Cast? Any chance of stress fracture instead of tendinitis?

Mike, our situations sound eerily similar. I think my injury is a little more toward my big toe. But mine travels around too. Have you had tendinitis before? As I said above, I have, and those times it traveled around as well, so I'm sort of used to that weirdness.

Yes, in the mornings, I feel pretty much crippled, sitting here nine days after the injury. It does then loosen up a little. Yesterday late afternoon / evening was the first time I really felt what felt like some healing.

How much running history do you have? It sounds like a fair amount, given your descriptions of your runs, so imho running a mile is good, will aid healing, and will keep the rest of your body in shape for when you DO return to full form.

I would not worry about taking the ibuprofen. As long as you're seeing some improvement, I don't think you're masking anything. FYI, the main reason I went to the doc was because I felt a "snap," and wanted to make sure nothing was damaged as opposed to just inflamed. The doc said that if I had an injury that might result in a surgical repair, I wouldn't be able to move my toes.

pasei, is your toe movement normal?

One other thought: Mike, from the reading I've done, the farther away from your big toe that your injury is, the longer it takes to heal because the blood flow is greater toward the inside of your foot. I haven't had any pain on the outside of my foot (though I have during other injuries). You might want to try some self-massage of those areas, to keep the blood moving. During my most recent ankle tendinitis, I did LOTS of self-massage of the area, and I think it quickened the healing.

FYI, I ran Grandma's Marathon with that injury, before it was 100% healed, and BQ'd. Then I ran a fall marathon and kicked ass -- 100% injury-free. We CAN come back from this stuff. We WILL!!!

Thanks for your long answer! Haha, I get pissed when I see people running too...!

So, I basically started running in 2011 (age 24), but I was only doing 2 or 3 miles, with no stretching, and with awful shoes, about 3 times a week.

Then mid-2012 I started being serious and bought good shoes, and in January 2013, I increased the length of my runs and I peaked at 34 mi/wk just before my injury (I clearly pushed too had, too soon).

Also, I didn't do much sport when I was a kid, some soccer, some tennis, but not too seriously. As a result I believe that my articulations/muscles/tendons are weaker than people who are playing american football every weekend since age 3.

After swimming, it hurt in the tendon above the foot, between the foot and the leg. But my friend (Doctor of Osteopathic Medicine) told me the brass was bad for my foot but crawl was OK, so that explains it.

Yeah - my toes are fine. Also, the doctor was sure it's not a SF, he said it would be swollen and it would hurt when he touches it. He didn't give me a follow up appointment, but he got me PT sessions in case it doesn't improve in a week.

I did play Ultimate yesterday for about an hour, it hurt a little bit at the end so I immediately put a Flector patch on it. Today my whole body is sore, including my BOTH feet, so I can't really tell if it's good or bad...

I guess I'll try a short run tonight see how it feels, then I'd go to the PT.

Aw, shucks (in US speak), you're young and will bounce back just fine!! I broke my ankle at age 25, that ankle (left, same as current injury) came back more flexible after the break than before (because of the PT).

I was a couch potato as a kid and didn't discover fitness till college. So we have that in common.

Re: your pain after swimming ... yeah, that's an interesting place for an injury. That being said, my tendinitis does move around a bit in the foot and toward the leg. I'm not overly concerned, since this my third bout with tendinitis. It will clear up, for the both of us ...

I've enjoyed this thread. I guess misery loves company. I had the same tendinitis last year and was in an air boot for about 5 weeks to speed the recovery. Without it, the Dr. said it could be 3 months. It took FOREVER to heal, in my opinion. Especially because it happened in wintertime in Atlanta...and I could not train all spring. Come the heat of July...I was good to go again. (Go figure)

I've only been running for about 3-4 years (47 yrs old) and feel I've had every foot injury/strain there is. This one, in one foot, is re-occuring. I've run 3 half marathons and just finished a 10K last week. I'm starting to feel the signs again of it and taking a couple weeks off.

I have to be training for my next half (which is in Oct) in the next couple weeks. I think I've tried every shoe possible. I have high arches and do not overpronate much. I've tried the creative lacing and it seems to work some times.

What works best for me, is ICE. I've noticed if I ICE immediately afterwards, and in the mornings, I'm okay. I feel the tingle every now and then....but get nervous of more strain without the proper healing.

I'm curious if anyone has tried ultrasound on it? Or vibration massage? I'm willing to do anything preventive to keep it at bay for my training.

I have continued to run every day through this and managing it through massage, eccentric Achilles exercises, calf stretches, glute strength exercises, and shoe choice. By running every day, I get continual feedback on whether its getting better or worse. For example, the day after I run in my Mizuno Wave Ronins is usually better than the day after I run in a pair of my othe shoes. Slowly but surely I am easing the mileage up, but with constant monitoring of what is working and what isn't.

Thank you, Chiquitabgood & Harbourboy. I appreciate your feedback. I've recently switched to Mizuno Wave Ronin and find the fit and support is best for me. I just get concerned with the lace pressure causing pain.

Such a frustrating injury. I THINK I'm on the rebound. Let's see ... I ran 3.1 at an 8:15 pace yesterday, 2.5 at a 9:20 pace two days before, 2.0 at a 10:20 pace two days before that, and really slow 1.5-mile run/walks and 1.0 walk/runs before that. Hoping to get out there tomorrow morning!

I've been careful not to go over the pain threshold at all. But ... I'm sensing that complete "no running" rest was not helping me heal. Not at least once I got the point where I could move around more at least.

I've been cross-training pretty consistently -- biking, swimming, elliptical, weights -- so trying to keep the cardio in order. Still planning to run the NYC Marathon; we'll see!

Hang in there all. It's a nasty one, but from all the reading I've done (and I've done a lot), no one has been sidelined forever by this kind of tendinitis. It can just take awhile. A long while. Ugh.

Also, I have flat feet and I used to run in motion control shoes... but my PT made me buy neutral (almost minimalist) shoes. I bought the Kinvara 4, and she told me to land more middle-foot (as opposed to heel). It seems to help a lot. Now my Achilles and plantar tendons are taking much more stress, so I have to be careful there. But ultimately that seems to be the solution!

I managed to do 4mi yesterday with virtually no pain. Still hoping to finish the Chicago Marathon mid-October. Finger crossed.

Thanks for the update. That's an interesting "prescription" from your PT. FYI, I was running in Kinvara 3s when my injury occurred. I think I was running too much on my forefront, and now I'm back in Saucony Ride 5s, which have lots of cushioning on the toe and are doing the trick for me. I'm not back to "normal," but I think I will be in 2-3 weeks. Hooray!

My latest plan is to get back into the Kinvaras, but I probably won't run much in them till after the NYC Marathon. Ultimately I'm hoping to do my short/fast runs in Kinvaras and Virratas, and the marathons and long runs in Saucony Rides.

I've had good luck in both. Ran a 3:15 in my Rides -- can't complain! But then I ran two marathons in Kinvaras with good results: 3:25:15 in Miami (hot, humid, lots of water stops, missed BQ by 15 seconds) and 3:20:59 (BQ) in Boston.

So not sure what to do, long-term. This injury has been a learning experience!

Anyway, pasei, SO GLAD you're getting some relief on this injury. It's a horrible and nasty one, isn't it??

Pasei That's interesting that your PT said to change your foot strike. Mine hasn't said anything about that. I am finding some relief with the deep massage & ultrasound therapy. Stretching irritates everything but I do it anyways... I will look into switching my shoes, I was in zigs then had switched to a Nike running show when my injury occurred. I'm a big heel striker so I probably should find a running expert to see if I need to change my running style, too. This injury seems to be more common than PTs let on. Another person at my gym has a boot on her foot bec of it-something my PT/ortho won't consider.

So, in my last post I said I ran 4 mi without pain... that's what I thought, but in actuality my tendon under the foot (plantar fasciitis I believe) is killing me... so apparently those new shoes (Kirvana 4) transferred the stresses from the top to the bottom of my foot. I need to be very careful here because I could get myself another tendonitis.

I guess I will have to wait a few days for the pain to go away (hopefully it will!) and then resume running shorter distances than that, and do stretches for the plantar fasciitis.

Hi Pasei, Steve and everyone ......I just came across this post today after doing some research on some soreness (not pain) that I've been having for about a week and a half now on the top of my foot. I wear the Asics Gel Nimbus 13's and on the newer pair I was using, it seemed I had the laces too tight and even that particular shoe itself, just seemed too snug as well....but I continued to run in them until today...... I haven't gone to the doc yet...just kind of "waiting it out" and accessing each run....I'm training for the NYC Marathon too, just like you Steve, and just hoping this uncomfortable soreness doesn't get any worse.

Keep on Keeping On Pasei and Steve!! Hope this nasty injury subsides for you both soon!!

I'm finally getting used to my new shoes. I'm doing A LOT of stretches throughout the day, and when I say "a lot" I mean it, maybe 3 times/hour (calves stretches). And it works! I ran 4mi virtually pain free (with bouts of walking). If you want more details you can check out my blog dickheadmarathon.blogspot.com!

Pasei, so sorry about the bottom of the foot soreness! I've had a little soreness on the bottom of my foot during the recovery process, but nothing major. What's the latest?

Donna, it sounds like you "nipped it in the bud." Congrats on getting into NYC. Also ... what's the latest with you? Thinking good thoughts.

I'm so happy I'm doing pretty well. I've been ramping up mileage-wise and pace-wise. I'll probably clock in at around 22 miles after this weekend. Paces are slower than what I had been running, but still respectable. I'm about 90% sure I'm going to run a half-marathon two weeks from tomorrow! Yay! It will not be a PR, far from it, but it'll be fun to run a race (though I did run a timed 5K a a couple weeks back and it went OK).

The tightness lingers, but it's a fraction of what it was.

I'm convinced that runs HELPED heal this injury. The trick is knowing when to get back to it. My first couple runs were pathetic -- mile-long endeavors at a 12:00 pace. But once I started feeling BETTER after a run than beforehand, I knew it was time to keep pressing it a little. I'm clawing back, having run 4 miles two days ago at a 6:45 pace. Almost back to where I was! Ugh!

I'm finally getting used to my new shoes. I'm doing A LOT of stretches throughout the day, and when I say "a lot" I mean it, maybe 3 times/hour (calves stretches). And it works! I ran 4mi virtually pain free (with bouts of walking). If you want more details you can check out my blog dickheadmarathon.blogspot.com!

I hope we all make our marathons happen!

Hi ya Pasei, it sounds like as of last month that you're doing good! I hope it's continuing!!

Your blog was sooooo interesting to read...it had me cracking up too at times!! I couldn't respond to it for some reason though :/

Thank for writing back!...I'm up to 33 miles per week now and the top of that foot still acts strange but no pain....I bought the new Asics 15's and laced them differently...but on my long runs, that foot acts up when I'm done...basically I've been massaging it and stretching it which seems to help..can't wait for NYC!!

Wow, that's awesome that you're going to do the Half in 2 weeks!! Cool and Good Luck with that~ Keep us posted!! Yeah, don't worry about the PR Steve...just stay focused on your recovery and take care of that tightness.

I agree with you in regards to knowing "when" to get back to it...I'm happy to hear that you did a 6:45 pace the other day, WOW!!!

Keep on Keeping on and Let us know how you do on your Half Steve!!

Well Wishes to You!!

Originally Posted by SteveInMinn:

Hi Donna and pasei and others!

Pasei, so sorry about the bottom of the foot soreness! I've had a little soreness on the bottom of my foot during the recovery process, but nothing major. What's the latest?

Donna, it sounds like you "nipped it in the bud." Congrats on getting into NYC. Also ... what's the latest with you? Thinking good thoughts.

Hello everyone- just a quick follow up.I've done 7 total sessions with a physical therapist- stretching, ice, ultra sound therapy and new insoles in my shoes. So far- I can walk without pain and can tolerate slow runs. I've been doing 3 miles regularly- but the pain flares up anything over 3. If I ice the foot- I'm fine by morning. Honestly, I highly recommend ice and stretching more than anything. The insoles cause a different type of pain, but I had to try them in order to eliminate a potential source for the pain. I did switch shoes again today to see if I could tolerate more than 3 miles- so far, that's not the answer.

It was all very encouraging to read all your posts. Sadly similar problems brought me here.

In the beginning of July I was trying minimalistic shoes and I really screwed. After 5 days I started to feel pain between heel and mid-foot on inner side and it didn't go away even when I switched back to old runners. I thought I give it a rest for couple of days, but it only got worse. I was heavily limping for about one week.

Now is the end of August and I managed to run 3 days straight 3-4mi, but the pain returned. It is not as intense and slightly moved towards the ankle, but it's extremely frustrating.

I run every day morning 4 miles now for 2 years. Before I was running 5mi 3 times a week and it really hurts mentally not to be able to run especially in the summer when the sun is up very early.

I'm 37 and I already had it once some 10 years ago but, I wasn't that bad. Back than I was 15kg lighter and 30% younger. So now I'm trying to loose extra weight, but I can see I wasn't really doing enough about it. I'll definitely try way more stretching massaging and ice.

ice, ice and more ice. also do lots of heel stretching and calf stretches. once youve done that, more ice. i took a couple of weeks off and then resumed running slowly. overall, it took me 3 months to get over this b/c i kept running too soon. but i finally took the advice of my doctor and took two weeks off and did what they said... it worked.

it might be your arches falling, it might be your shoes... its kind of a crap shoot on what caused your foot pain, and you might want to go see a physical therapist...

Laura -- glad it sounds like you're close to back to normal! For me at least, it was a close call about when to go back to running. Because I've been running so regularly for 26 years, I'm convinced that running helps the healing -- but only if you don't do it too soon. Tough one.

lombausch -- Aw, shoot, so sorry you're dealing with this. Not sure you and I have/had the same thing, because my pain is/was right across the top of my foot, mainly toward my big toe.

But many other similarities. I too was a longtime, everyday, but not-too-far-in-distance runner. And the mental effect of not running was nearly overwhelming. Very, very difficult. And oh so difficult to see others running on a gorgeous day. I did do a lot of biking, which helped, because at least I wasn't in a sweaty gym on a nice day, but there's no replacement for running. None.

Ice packs worked well for me, and stretching once I was into the healing process. I still stretch the top of my foot regularly. And it's not 100% gone. I took an 8.5-miler this morning, on a very humid day, and felt some recurrence. But I've elevated it for the evening and it feels pretty good.

you know, i am almost back to 100%, had to use some ice last night- but only b/c i felt alittle tweak of pain in the bottom of my arch after a 45 min run. As of now, it feels pretty good. no swelling and/or searing pain

Laura -- pretty much the same here. I'd say I'm at 98%. I'm in the throes of training for the NYC Marathon, so doing some long runs. Felt a little tightness after a humid 9-miler Wednesday, but went away within a few hours. Planning an 18-miler Sunday.

More of a challenge has been fending off other injury, since I was away from running for eight (horrible) weeks.